Integrative Studies

1. Coronary Artery Risk Development in Young Adults (CARDIA) Study

Core group members and network collaborators continue to mine the data from this longitudinal study of cardiovascular risk factors among African-Americans and Whites in four U.S. cities (Birmingham, Chicago, Minneapolis and Oakland). The study recruited 5115 men and women in l985 stratified by age (18-24 years and 25-30 years), sex, ethnicity (black and white), and educational level (high school graduate or less and beyond high school). Seven follow-ups have been conducted, and retention has been good. A particular strength of this study is the availability of excellent measures of socioeconomic status, psychosocial factors, and biological indicators in a diverse population, including data from the sociodemographic and psychosocial questionnaires, and the allostatic load battery of biological measures, all of which the network designed for the 15-year (2000-2001) CARDIA exam. With repeated measures of SES, major cardiovascular risk factors, and health outcomes, including hypertension, diabetes, obesity, metabolic syndrome and coronary calcification this data set is a rich resource for testing our pathways model. Analysis centers are established at UCLA, Stony Brook and UCSF.

The psychosocial context and consequences of race:
extent of black-white differences in the broad range of psychosocial factors assessed and the extent
to which they contribute (independent of and in combination with SES) to racial differences in
coronary calcification, diabetes, and hypertension.

Race, age, and allostatic load: Is there an age patterning to
the racial differences in allostatic load? That is, are markers of allostatic load evident at earlier ages for
African Americans than for whites?

Williams and Seeman

UCLA

On hold.

SES, allostatic load and mental health:
The mediating role of cumulative risk.

Evans, Seeman, Gruenewald,
Matthews, Epel, Williams

UCLA

Analyses in progress.

Delineating subtypes of early family environments
that confer physical and psychological risk.

Saxby, Taylor, Seeman,
Gruenewald, Kiefe

UCLA

Analyses in progress.

Biological correlates of social integration, social
support and social conflict.

Influence of Race, Gender, and Marital Status on the Development
of the Metabolic Syndrome

Kiefer, Adler, Matthews

UCSF

Analyses in progress.

Racial differences in blood pressure trajectory in a
biracial cohort: The CARDIA study.

Schwartz, Ogedegbe, Williams, Cohen, Matthews

Stony Brook

Analyses in progress.

2. Whitehall II

This longitudinal study of 10,308 British civil servants, initiated in 1985, has been central to our ongoing integrative studies. It offers a unique opportunity for studying the relationship between SES and health in an occupationally based population. Respondents span the range of employment grades from office support to permanent secretary, with a 20-fold salary range. They have been well-characterized in terms of social position: economic/material (personal income, household income, wealth), occupational (employment grade), educational (years of education; qualification obtained), and parental social class. Measures of health, lifestyle, work characteristics, social support and life events have been repeatedly obtained over 22 years. With an increasingly large population of older citizens in the UK the Whitehall team seeks: (1) to determine the degree to which occurrence of cardiovascular disease and social inequalities at older age are produced by contemporaneous circumstances and by prior cumulative exposures to risk factors during working life, (2) to test the hypothesis that the functional consequences of living with increased cardiovascular risk in later life are modifiable, and (3) to understand social differences in the progression of cardiovascular risk based on longitudinal analysis of repeated measures.

During the course of our collaboration with the Whitehall team we have intellectually and financially supported a number of young researchers, including Meena Kumari, Tarani Chandola, Archana Singh-Manoux, and Mai Stafford. Many publications have resulted from this collaboration. Having both the CARDIA and Whitehall samples has allowed for comparison analyses, for example, a paper comparing the association between subjective socioeconomic status and health between different ethnic groups in Whitehall II and CARDIA was published in 2008 (Adler NE, Singh-Manoux A, Schwartz J, Stewart J, Matthews K, Marmot, MG. Social status and health: A comparison of British civil servants with European- and African- Americans). It replicates Whitehall analyses published in 2003 (Singh-Manoux A, Adler NE, Marmot M. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 2003; 56:1321-33).

3. Large industrial company

The Industry Study was initiated with Network support in 1998 by Mark Cullen. This study includes 25,000 employees of a large industrial company at 15 industrial plants scattered around the US; over 20% are non-white and over 25% are women. This rich data set includes complete demographics, work histories and work performance measures for all workers since 1985, continuous and complete health insurance and various physical status measures since 1996, and key information about physical and social characteristics of each job and each work location. Network support has allowed these data bases to be linked, making possible analyses of health effects of job categories and work conditions. Work proceeds looking at the role of physical and psychosocial characteristics of jobs and work locations as they predict physical injury, chronic disease, mental health outcomes, and disability. There is also an increased focus on utilization of care and quality as it may impact the relationship between SES and health.

In 2006 the study received funding from NIA for a five year project totaling 5.5 million dollars ("Disease, disability and death in an aging workforce") which will ensure the continued work on these issues. This is a good example of how an investment of network funds resulted in far greater support for a major research initiative. In addition, the richly linked database whose assemblage was funded by the network has allowed members of the team to obtain a number of smaller grants and awards, and has resulted in seven dissertations. Four collaborations with network members are of particular note: with core group member Ichiro Kawachi and post-doctoral fellow Jane Clougherty, a major multilevel analysis of the causes of chronic disease; with Sheldon Cohen and his colleagues, an analysis of the impact of job stress on risk for lung function lost longitudinally; with Joe Schwartz, an assessment of the predictive value of the externally rated job demand survey versus the Karasek quality of employment survey on injury risk; and with Michael Marmot, a comparison of the externally rated job demand survey in Whitehall and this company's populations.